Health inspectors have revealed a morale gap in the U.K's National Health Service between popular health trusts with highly motivated staff and others that are struggling to maintain employees' enthusiasm and loyalty. Between October and December 2008, the Healthcare Commission asked 160,000 employees across 390 NHS organizations in England whether they would recommend their trust as a place to work. At the top end of the scale, 87% of staff at Queen Victoria foundation hospital in East Grinstead said they would recommend it. At the bottom end, only 16% of staff at the Great Western ambulance service said they would recommend it.
With the Jamaican economy suffering several recent setbacks, the director of the country's Chamber of Commerce is calling for significant investments in health tourism to replace lost earnings. According Keith Collister, purpose-built hospitals to attract foreign clients would more than make up for the earnings lost from ailing sectors.
Under a new program by the National Health Service, everyone aged between 40 and 74 in England will be invited for tests every five years to identify their risk of coronary heart disease, stroke, diabetes, and kidney disease. More than two million people will be assessed each year and officials believe the checks could save 650 lives each year.
In 2001, Thailand extended government-financed coverage to all uninsured people with little or no cost sharing, and a new study published by Health Affairs found "the country has added nearly fourteen million people to the system and achieved near-universal coverage without compromising access for those with prior coverage." The "30 baht" program is named for the goal of ensuring that no individual is charged more than 30 baht (about 84 cents) for any inpatient or outpatient visit, and for prescription drugs.
With the announcement that the federal government's plans to spend $19 billion to spur the use of computerized patient records, the industry has a renewed interest in how and when hospitals should begin to adopt electronic health records.
But what about hospitals already entrenched in EHR? What's next for them?
Physicians at the Medical Clinic of North Texas have been using an EHR for nearly 10 years, says CIO Mike Yerrid. He will be focusing on expanding into the health information exchange arena, to connect other physicians within the Dallas-Fort Worth region, with the eventual goal of establishing a medical home model.
"We are a large primary care medical group, and there's value to exchanging our electronic information with other groups in the area," says Yerrid. "We're hoping people will join the game. We're trying to sell the benefits and create an attractive package for specialists and primary care groups."
States and counties throughout the country have experienced varying levels of success when it comes to getting HIEs and RHIOs off the ground. Respondents to the HealthLeaders Media Industry Survey 2009 were split fairly evenly on the topic. We asked them, "Which of the following best describes your thoughts about regional data sharing projects, known as RHIOs?" About 37% of CIOs said they expect RHIOs to take hold over the next decade, another 35% said they expect them to fizzle due to lack of funding or management issues, and the remaining 28% said it's too early to be concentrating on RHIOs and the industry should first focus on automation efforts.
Yerrid says he expects the medical group to face interoperability issues. "It will be a challenge. It's one of those situations where if you had the only phone in the world, what value is the phone? And in the past one of the main problems with creating an HIE has been finding a revenue model that works. Our plan is to use the stimulus money to invest in the future, rather than pay ourselves back," he says.
Despite the challenges (interoperability, revenue, funding) that surround launching an HIE, the number of operational health information exchange initiatives increased considerably between 2007 and 2008, according to the eHealth Initiative. eHealth's eHealth's latest survey results indicate 42 operational HIE initiatives, up from the 32 in 2007 (a 31% increase). All 32 operational health information exchange initiatives that responded in 2007 continued to be in operation in 2008.
Yerrid says he expects that number will grow once the stimulus money begins to flow. "I think people are starting to see the real value that can be had from exchanging information this way. The creation of medical homes, by connecting specialists and hospitals, and the rest, is really the way we are going to expand coverage and improve healthcare," he says.
Since many hospitals are hunkering down and putting projects off to ride out the bad economy, Yerrid says now is the time to be performing due diligence to ensure all of the government's available incentives are being maximized. Once things get better, he says, that will be the time to begin to ramp up HIE efforts again.
"From an IT perspective, we don't always have to be running at full throttle, and this is one area where I think we can just tap the breaks a little bit. With that said, we're maximizing our e-prescibing incentives, our PQRI incentives, and working with pay-for-performance objectives to max those revenues so that when things do get better, we'll be ready to move forward quickly," he says.
There have been some small wins when it comes to advancing HIEs. And though 31% growth is incremental and not momentous, it's important to remember that increase came about before the stimulus plan was announced. Once that money starts coming in, more healthcare organizations will follow in the footsteps of Medical Clinic of North Texas.
—Kathryn Mackenzie
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While a national survey recently found that most U.S. hospitals are behind the curve on implementing electronic medical record systems, nearly all facilities in the Sacramento, CA, area have already begun putting such systems in place. However, one hospital system—Sutter Health—has been slow to implement an EHR system, citing the country's current economic troubles.
New reasearch suggests that a five-in-one polypill could guard against heart attacks and strokes for those over 55. Although progress on the research has been slow over the past five years, there is a trial of the pill currently being conducted in India. And it has already shown that the pill has "the desired effects and is safe and well-tolerated by those who take it." There are some medical experts, however, who question the ethics of the pill as it relates to lifestyle issues—they believe such heart-related problems should be tackled with diet and exercise rather than merely "popping a pill."
The Obama administration set new terms for private Medicare plans that are aimed at protecting sick patients from paying high charges and giving consumers a clearer idea of what the plans cover. The changes, announced by the Centers for Medicare and Medicaid Services, are part of conditions that insurance companies must meet if they want to bid on Medicare insurance business this year. Administration officials said the changes are intended to weed out certain out-of-pocket costs charged by Medicare Advantage, the private version of the federal health-insurance program for the elderly.
As Congress begins to grapple with health reform, an influential senator is looking hard at one of the medical insurance industry's most controversial practices and raising questions about how well insurers are regulated. Senator John D. Rockefeller IV, the West Virginia Democrat who is chairman of the committee on commerce, is holding hearings on whether health insurers have systematically short-changed patients when they use doctors outside of their health plan's network. The companies are accused of underpaying consumers by hundreds of millions of dollars over the last decade.
Nearly two dozen hospital employees have been fired or disciplined for snooping into the medical records of octuplet mother Nadya Suleman, according to Kaiser Permanete officials. The computer breaches at the hospital were discovered about 10 days ago and reported to state authorities and to Suleman, said Kaiser spokesman Jim Anderson. He said that 15 employees were fired and eight were disciplined. The employees "ran the gamut of medical staff," he said.
